Aversion therapy
Aversion therapy is a behavioral psychology technique aimed at changing undesirable behaviors by associating them with unpleasant stimuli. Originating from the principles of classical conditioning, as demonstrated in early experiments by Ivan Pavlov and later John B. Watson, the approach involves creating a negative association to discourage certain behaviors. Historically, aversion therapy has been utilized in various contexts, including the treatment of alcohol addiction, where individuals were conditioned to associate drinking with nausea through emetics or medications like disulfiram.
In the past, aversion therapy was controversially applied to attempts at "curing" homosexuality and other sexual orientations, often resulting in inhumane treatments and significant psychological harm. The practice has largely fallen out of favor, particularly after the American Psychiatric Association's decision in 1973 to declassify homosexuality as a mental illness. Today, more ethical alternatives, such as systematic desensitization, focus on gradually reducing anxiety associated with phobias or compulsive behaviors without the use of aversive stimuli. Despite its historical use, current practices prioritize humane treatment methods, reflecting an understanding of individual rights and the complexities of behavioral health.
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Subject Terms
Aversion therapy
- TYPE OF PSYCHOLOGY: Learning
- Aversion therapy aims at replacing undesirable learned behavior with desirable behavior by associating the targeted behavior with something unpleasant.
Introduction
Aversion therapy, or the use of stimuli to change unwanted behavior, derives from the experiments of Nobel Prize–winning Russian physiologist Ivan Petrovich Pavlov in the early 1900s, wherein dogs exhibited a learned response by first salivating in the presence of the attendant who regularly fed them and later salivating at the sound of the bell that rang to announce the attendant bringing their food. Classical conditioning, as illustrated by Pavlov, involves an unconditioned response (salivating) to an unconditioned stimulus (food), accompanied by an emotional reaction of pleasure. Exposed to a neutral stimulus (bell) that sounded immediately before the food was served, the dogs, in time, exhibited a conditioned response (salivating) to the sound of the bell rather than the serving of the food, resulting in the neutral stimuli becoming the conditioned stimuli (bell) and eliciting a conditioned response (salivation).
In 1920, another early practitioner of behaviorism, John B. Watson, demonstrated classical conditioning in the case of Little Albert, a child who was fond of playing with rabbits. When Albert made contact with a rabbit, Watson produced a loud clash behind Albert’s head, frightening the boy, who came to associate the sound with the rabbit. Eventually, he became terrified of animals.
Classical conditioning, through which one develops an aversion to food thought to have caused illness, was explored by John Garcia in an experiment involving irradiated rats that avoided sweetened water because they associated it with nausea. The Garcia effect differed from Pavlov’s behavioral finding in that although Pavlov’s stimulus required repeated applications, Garcia found taste aversion occurred after only one stimulus.
Taste aversion was first used in the 1930s as a cure for alcohol addiction. Individuals were given emetics (substances that induce vomiting) before they drank alcohol, eventually leading to their associating alcohol with nausea. In later years, persons participating in aversive therapy for alcohol addiction have been hospitalized to undergo an extended process of conditioning, and other programs advocate the use of electric shock rather than emetics. In the twenty-first century, the most common aversion therapy used to treat alcohol use disorder is disulfiram (Antabuse). This medication induces headaches, heart palpitations, nausea, and vomiting when the individual drinks alcohol, creating an aversion to the substance. Classic conditioning techniques are also used as curatives for overeating, smoking, and substance abuse.
Other Behaviors
Aversion therapy figured prominently during the 1950s and 1960s in efforts to “treat” homosexuality. Believing homosexuality to be a mental illness, those trying to “cure” homosexuality frequently required individuals to look at “inappropriate” images of sexuality while emetics were being administered, with the aim of conditioning the individuals to associate same-sex acts with nausea. Later, electric shocks replaced the emetics. Similarly, transgender individuals were made to stand barefoot in an electrified area, where they continued to receive electric shocks until they removed all vestiges of "gender-inappropriate" clothing. “Treatment” for exhibitionism worked in the reverse; exhibitionists were shocked until they stopped exposing themselves. Aside from being inhumane, aversion therapy for perceived sexual deviance did not produce the desired results and some individuals became suicidal. The use of aversion therapy on individuals of the LGBTQIA+ community declined after the rise of the gay rights movement in 1969, although its decline is attributed not as much to the movement as to the American Psychiatric Association’s removal in 1973 of homosexuality from the list of mental illnesses. This change suggested that gender identity and sexual orientation are not an illness and, therefore, not something to be cured, but something that develops over an individual’s lifetime and involves little if any choice.
Individuals with strong gambling urges may undergo aversion therapy wherein small electric shock devices are strapped to their wrists and used to shock them whenever they view gambling paraphernalia, such as betting forms or written material that appeals to their interest in gambling.
Intense fears or phobias are treated by a process known as systematic desensitization, developed by South African psychiatrist Joseph Wolpe, in which the individual systematically moves from the least-feared situation or object to the most-feared. Using relaxation techniques, the individual with the phobia undergoes a gradual process, coping with successively more frightening situations or objects, until the fear is gone.
Initially designed to help children lose their fear of animals, the desensitization process has also been used to help children and adults cope with fears such as an intense aversion to spiders. Over a period of time, people progress from seeing spiders at a distance, to coping with being in the same room with them, to touching them, and finally to allowing them to crawl up their arm and onto their faces. Each step reduces the fear by proving that what the person feared the most does not happen. This process has worked well in overcoming a fear of flying. Individuals gradually, in a relaxed manner, progress from paralyzing fright to flying without fear, and in some instances to flying their own planes. Occasionally, in an attempt to eliminate a fear of heights, individuals are subjected to flooding; instead of undergoing a gradual process, individuals are immediately taken to a high location to bring home the fact that nothing bad has really happened to them.
Because of the ethical issues and risk of physical harm associated with many forms of aversion therapy, most individuals in the twenty-first century are treated instead with a behavioral therapy technique called covert sensitization. Additionally, experts have questioned the long-term efficacy of aversion therapy.
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